NR 509 FINAL EXAM WITH
CORRECT ANSWERS 2025
GRADED A+
CHAPTER 18: Breasts & Axillae
A 44-year-old female mathematician presents to clinic with a
complaint of a mass in the right breast. Her partner noticed this
mass 2 days ago, and the patient feels guilty because she has
only had one mammogram and does not engage in breast self-
examination (BSE) on any regular basis. She has no family history
of breast cancer, and her prior mammogram was ordered as a
routine screening test at age 43 years after a brief discussion with
her primary care provider. After a thorough investigation reveals
a benign cyst, what advice should be given to this patient about
screening for breast cancer in her age group?
a. BSE is well evidenced, and all recommending agencies agree
that it should be taught and reinforced.
b. Clinical breast examination (CBE) is superior to BSE and should
be a routine part of annual examinations starting at age 30 years.
c. This patient was in compliance with the correct answers >>
c. This patient was in compliance with the U.S. Preventive
Services Task Force (USPSTF)
recommendations for her age group and risk factors prior to her
current complaint.
GRADED A+
,CHAPTER 18: Breasts & Axillae
A 42-year-old female website developer presents for an annual
preventive examination with questions about breast cancer
screening. She is concerned about the radiation exposure
associated with mammography and is interested in magnetic
resonance imaging (MRI) as a possible alternative for routine
screening. She is otherwise healthy with no family history of
breast, ovarian, or colon cancer. Which of the following is true
about MRI as a screening modality for breast cancer in the
general population?
a. Breast cancer screening by MRI has been well studied in the
general population.
b. Sensitivity of screening for breast cancer increases with breast
MRI at the expense of specificity.
c. This patient is an ideal candidate for screening via breast MRI
based on current evidence.
d. Women at low lifetime risk of breast cancer (<20%) are
recommended to undergo screening MRI.
e. Known BRCA1 or B correct answers >> b. Sensitivity of
screening for breast cancer increases with breast MRI at the
expense of specificity.
CHAPTER 18: Breasts & Axillae
A 35-year-old G0P0 woman presents to clinic with a complaint of
bilateral nipple discharge. This discharge started several weeks
ago and has occurred at irregular intervals since that time. She
GRADED A+
,does not complain of local tenderness, redness, fever, or any
other systemic symptoms aside from slightly irregular periods
over the last few months. On examination, she is able to express
a small amount of discharge, which is sent to the laboratory and
found to be consistent with breast milk but without any signs of
blood or pus. Screening laboratories are also sent, which reveal a
normal blood count, metabolic panel, thyroid-stimulating
hormone, and human chorionic gonadotropin (HCG) level. Further
laboratories are still pending. Which of the following is the most
likely diagnosis?
a. Mastitis
b. Ductal carcinoma in situ
c. Paget disease of the breast
d. Occult pregnancy
e. Prolactinoma correct answers >> e. Prolactinoma
CHAPTER 18: Breasts & Axillae
A 22-year-old G0P0 undergraduate student presents to clinic after
finding a breast mass on breast self-examination (BSE) at home.
The mass is nontender without skin changes, erythema, or
overlying swelling. She has heard that most breast cancers are
found by patients themselves, and she is very concerned that she
may have breast cancer. Which of the following is true about BSE
and self-detection of breast cancer?
a. Most masses that women find at home and bring to a provider's
attention turn out to be malignant.
GRADED A+
, b. This patient is more likely to find a fibroadenoma than a cancer
on self-examination.
c. The most likely breast mass this patient is likely to find in
herself is an abscess complicating underlying mastitis.
d. Because of this patient's age, breast masses should not be
pursued with imaging and diagnosis because the risk of cancer is
so low.
e. BSE is universally recommended b correct answers >> b.
This patient is more likely to find a fibroadenoma than a cancer
on self-examination.
CHAPTER 18: Breasts & Axillae
A 48-year-old female psychologist presents to clinic with concerns
about her breast cancer risk after an age-matched cousin was
recently diagnosed with this disease. This cousin is the third
family member on her father's side in as many years to be
diagnosed with breast cancer, including the patient's own father,
who had surgery and subsequent treatment 3 years ago for
breast cancer. The patient has little other knowledge of her family
history, only that her grandparents independently arrived from
Eastern Europe near the end of World War II and were among
very few members of their family that survived the war. The
patient has read about testing for the breast cancer genes
(BRCA1 and BRCA2) and desires further information about
whether this would be appropriate for her. Which of the following
is true about this patient's indications for BRCA testing?
a. Her familial lineage is irrelevan correct answers >> d. This
patient carries several risk factors that together justify BRCA
testing.
GRADED A+
CORRECT ANSWERS 2025
GRADED A+
CHAPTER 18: Breasts & Axillae
A 44-year-old female mathematician presents to clinic with a
complaint of a mass in the right breast. Her partner noticed this
mass 2 days ago, and the patient feels guilty because she has
only had one mammogram and does not engage in breast self-
examination (BSE) on any regular basis. She has no family history
of breast cancer, and her prior mammogram was ordered as a
routine screening test at age 43 years after a brief discussion with
her primary care provider. After a thorough investigation reveals
a benign cyst, what advice should be given to this patient about
screening for breast cancer in her age group?
a. BSE is well evidenced, and all recommending agencies agree
that it should be taught and reinforced.
b. Clinical breast examination (CBE) is superior to BSE and should
be a routine part of annual examinations starting at age 30 years.
c. This patient was in compliance with the correct answers >>
c. This patient was in compliance with the U.S. Preventive
Services Task Force (USPSTF)
recommendations for her age group and risk factors prior to her
current complaint.
GRADED A+
,CHAPTER 18: Breasts & Axillae
A 42-year-old female website developer presents for an annual
preventive examination with questions about breast cancer
screening. She is concerned about the radiation exposure
associated with mammography and is interested in magnetic
resonance imaging (MRI) as a possible alternative for routine
screening. She is otherwise healthy with no family history of
breast, ovarian, or colon cancer. Which of the following is true
about MRI as a screening modality for breast cancer in the
general population?
a. Breast cancer screening by MRI has been well studied in the
general population.
b. Sensitivity of screening for breast cancer increases with breast
MRI at the expense of specificity.
c. This patient is an ideal candidate for screening via breast MRI
based on current evidence.
d. Women at low lifetime risk of breast cancer (<20%) are
recommended to undergo screening MRI.
e. Known BRCA1 or B correct answers >> b. Sensitivity of
screening for breast cancer increases with breast MRI at the
expense of specificity.
CHAPTER 18: Breasts & Axillae
A 35-year-old G0P0 woman presents to clinic with a complaint of
bilateral nipple discharge. This discharge started several weeks
ago and has occurred at irregular intervals since that time. She
GRADED A+
,does not complain of local tenderness, redness, fever, or any
other systemic symptoms aside from slightly irregular periods
over the last few months. On examination, she is able to express
a small amount of discharge, which is sent to the laboratory and
found to be consistent with breast milk but without any signs of
blood or pus. Screening laboratories are also sent, which reveal a
normal blood count, metabolic panel, thyroid-stimulating
hormone, and human chorionic gonadotropin (HCG) level. Further
laboratories are still pending. Which of the following is the most
likely diagnosis?
a. Mastitis
b. Ductal carcinoma in situ
c. Paget disease of the breast
d. Occult pregnancy
e. Prolactinoma correct answers >> e. Prolactinoma
CHAPTER 18: Breasts & Axillae
A 22-year-old G0P0 undergraduate student presents to clinic after
finding a breast mass on breast self-examination (BSE) at home.
The mass is nontender without skin changes, erythema, or
overlying swelling. She has heard that most breast cancers are
found by patients themselves, and she is very concerned that she
may have breast cancer. Which of the following is true about BSE
and self-detection of breast cancer?
a. Most masses that women find at home and bring to a provider's
attention turn out to be malignant.
GRADED A+
, b. This patient is more likely to find a fibroadenoma than a cancer
on self-examination.
c. The most likely breast mass this patient is likely to find in
herself is an abscess complicating underlying mastitis.
d. Because of this patient's age, breast masses should not be
pursued with imaging and diagnosis because the risk of cancer is
so low.
e. BSE is universally recommended b correct answers >> b.
This patient is more likely to find a fibroadenoma than a cancer
on self-examination.
CHAPTER 18: Breasts & Axillae
A 48-year-old female psychologist presents to clinic with concerns
about her breast cancer risk after an age-matched cousin was
recently diagnosed with this disease. This cousin is the third
family member on her father's side in as many years to be
diagnosed with breast cancer, including the patient's own father,
who had surgery and subsequent treatment 3 years ago for
breast cancer. The patient has little other knowledge of her family
history, only that her grandparents independently arrived from
Eastern Europe near the end of World War II and were among
very few members of their family that survived the war. The
patient has read about testing for the breast cancer genes
(BRCA1 and BRCA2) and desires further information about
whether this would be appropriate for her. Which of the following
is true about this patient's indications for BRCA testing?
a. Her familial lineage is irrelevan correct answers >> d. This
patient carries several risk factors that together justify BRCA
testing.
GRADED A+
